Seriously Super Surgery with Dr. David Grauer and Flatiron Surgery Center

When I mentioned on Facebook I needed knee surgery, I received a few recommendations for Dr. Grauer. I managed to get in to see him for a consult within a day, and he was great; took the time to explain the various options I had and then we set up an appointment for the surgery the next week. After a month of limping around, I was eager to have it looked after.

As the time grew nearer I was a bit more nervous, but my parents came to Boulder to look after me for a few days, which was great.

Yesterday was the big day: originally my check-in was scheduled for 8:45 for a 10:15 surgery, but it got pushed back to check-in at 10:15 for an 11:45 surgery. I joked that that just gave me more time to be hungry before the appointment (I couldn’t have any food or drink after midnight) but the time passed not too bad and I surprisingly didn’t get too anxious in the extra time.

Things were running behind so we waited in the waiting room for awhile, and then once I was brought back to prep I had some more time to wait. My pulse was a nice relaxed 56BPM, despite being ready to undergo a medical procedure. The radiologist and Dr. Grauer both came in to see me, as well as a steady stream of nurses to check on me. My parents came back and waited with me for awhile and then at close to 1pm it was go-time! The anesthesiologist got me started and by the time they’d wheeled me into the operating room I was nearly gone.

Unlike past surgeries where I’ve woken up groggy and confused (in one case I kept trying to sit up and was told to lay back down), in this case it was as though I just woke up from a good sleep: I wasn’t groggy or confused. I was wheeled out to the recovery room to enjoy some apple juice and apple sauce (no crackers please and thanks…) and then my parents were allowed to come see me. Apparently the surgeon had been out to chat with them. I was given some instructions for recovery and was surprised that I was at least somewhat lucid enough to understand them. The nurse told me I had to keep the dressing on my leg until my follow-up appointment, to which I asked her what kind of dressing – ranch? vinagrette? I took this as a sign I was doing well – it probably actually meant the drugs were still working 🙂

The piece of my cartilage that was broken off was apparently bigger than they expected – nearly a half-inch- and so they performed a mosaicplasty. They removed two small pieces of cartilage from elsewhere in my knee to form plugs to fill in the hole. I’m glad to hear they went with this procedure because I anticipate it will be better for my future activity.

donjoy knee braceI was surprised I was put in a Donjoy X-Act Post-Op brace, as I’d thought I would have to keep the joint moving throughout the day. Instead, I was told to keep it immobile for healing. I asked the nurse about it, and apparently I’d also asked Dr. Grauer after the surgery in a conversation I don’t recall…

My blood pressure was a little high so I had to wait around a bit, and I did feel a little sore and icky so I started on my Percocet and had some anti-nausea medication before we left the hospital. I’d been told to take Percocet every 4 hours to keep things under control – because there are three areas of impact, it was anticipated to be a little more painful than had they done the microfracture. The nurse told me to take note of whether I urinated or not within the first 24 hours; if not, I’d have to come back and have a catheter put in. I promptly told her that wouldn’t be an issue, and asked to use the restroom right then! On the road to recovery!

We were home around 4:30 pm and I actually felt just fine – not really groggy as I had anticipated. I had a green smoothie (which tasted great after nearly 24 hours of not eating!) and then some miso soup and a bit of a Boulder Veggie bowl from Tokyo Joes. Again, I was really surprised that my stomach felt ok. I read a bit and went to bed at a reasonable hour (10:30) and drifted off just fine, despite the fact my leg was in a brace and elevated.

20130620-200138.jpgAt midnight and 4am, my Percocet alarm sounded and I had a couple rice chips and a pill. The only downside was that it was difficult to drift off to sleep again afterwards: I just didn’t feel sleepy (probably because I hadn’t expended much energy that day).

Today’s been great as well – had a green smoothie and a Bhakti Chai coffee blend drink for breakfast, relaxed and read and listened to podcasts. I’ve taken the meds on the schedule they gave me, but the ‘pain’ has really not gone above a dull ache, perhaps a 2 on a scale of 1-10. A nurse from the surgical center called me around 11 and asked how I was, if I’d been able to eat at all. I nearly laughed! My swelling has also gone down amazingly – I’ve had to tighten the straps on my brace a good inch and a half all the way down.

Today we went for a drive in the afternoon and I crutched around to a restaurant on Pearl St. Apparently using crutches is like riding a bike, I feel quite comfortable using them, although my sides where I am holding the crutches against my body is a bit tight (I have them short enough they’re nowhere near my armpits).

The other thing I was warned about was the ability of the percocet to cause constipation, so I made it my goal to have a bowel movement today. Sure, that’s probably not something you completely have control over (haha), but I wanted to do my best. It helps when you eat the way I do – two green smoothies, a chai/coffee blended beverage and then hummus, falafel and veggies, and I reached my goal! Which is pretty good considering it’s easy to find blog posts like this one: Life After Knee Surgery – Week 1: Percocet, Sleep and Constipation.

Indeed, it seems I’m scoring a big A on recovery – very little discomfort, good bodily functions, no grogginess. It’s probably strange to say, but I am really SO thankful I got this looked after and I’m very optimistic for the future.

I’ve determined that Injury Madness is worse than Taper Madness and I’m eagerly reading up on different events for the fall and next year. I have no reason to believe I’ll be hindered in any way by this setback. The whole experience was very positive and I’m so glad I selected the team I did!


  • Saw your post on Deb Conley’s FB page. I posted some post surgery nutritional info separately. I have 2 cadaver plugs in my left knee (surgery Oct 2012) and 3 TruFit plugs in my right knee (surgery Dec 2007). My left knee landed on a sharp rock when I fell on a Green Mountain trail, tearing lateral & medial meniscus, & doing cartilage damage. Both knees are as good as new; my primary activities are hiking and trail running. Thought you might find a few articles of interest, comparing microfracture to cartilage plugs. Plugs = far superior outcome and much faster recovery time, assuming you do your recovery homework and spend time on an exercycle every day. 8 weeks post surgery I ran 1 mile. Happy to talk to you about what I did to facilitate a pretty fast recovery; feel free to email me.

    Article comparing microfracture and cartilage plugs (OATS procedure = cartilage plugs):

    Clinicians evaluated patients prior to surgery and at one, two, three and five years of follow-up. They used a variety of tools commonly used to measure outcomes in patients undergoing these types of procedures. They used the short-form (SF)-36 health survey, a 36-question scale that includes a gamut of questions about general health and is widely used across all fields of medicine. They used two knee specific questionnaires: the international knee documentation committee (IKDC) scores and the Knee Outcome Survey (KOS). And they used the Marx Activity Level that is scored on a scale from 0 to 16 and gauges a person’s ability to do four activities: running, cutting, decelerating, and pivoting.

    They found no difference in the knee outcome surveys or SF-36 form, but they did identify significant differences in the Marx Activity Level. Patients who underwent the OATS procedure had higher scores than patients who underwent microfracture at one year from baseline (score 5.21 vs. 4.11), two years (7.29 vs. 3.71), three years (7.75 vs. 2.91) and five years (8.55 vs. 2.89).
    “The Marx activity rating scale correlates directly to the amount of physical activity that you can do at the time of the assessment,” said Dr. Williams. “Patients who underwent the OATS were able to do more sports and more athletic activities compared to the microfracture group at the same time point.

    What’s New in Cartilage Repair

    • Hmm… I wonder if they are thinking my recovery will take longer since they took plugs from elsewhere in my own knee, so I have three compromised spots. I’ll definitely ask when I go in next week!

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